The peri-urban settings of Kinshasa in the Democratic Republic of Congo are mostly characterized by uneven terrain and limited access to water. A cross-sectional epidemiological study of school-going adolescent girls identified public health risks associated with daily water carrying. Data were collected using a semi-structured paper questionnaire, whereas descriptive and regression analysis was performed using SPSS software. The study established that Head-load transportation of water was the most common mode for 92.3% of the interviewed adolescent girls. Compared to other modes, this mode was most likely to expose adolescent girls to musculoskeletal pains and injuries (p < 0.0001). Most adolescent girls interviewed (79.4%) crossed hilly and mountainous terrain. Some 59.4% of adolescent girls experienced falls, 38.6% and 17.4%, respectively, experienced injuries and strains associated with hilly terrain. Almost all the study participants reported pain (96.3%), with 73% reporting back and chest pains. Other reported problems included permanent muscular pain (59.5%), neck pain (55.6%), permanent headaches (50.6%), lower abdominal pain (23.1%), and prolonged painful menstruation (6.7%). Although these data are based on self-reported pain and injuries, their effects could negatively impact adolescent girls’ school attendance and performance. Evidence from this research first supports policies that provide home water supply systems. Such a supply system offers the advantage of relieving the burden of transporting heavy loads of water over long distances and mountainous terrains. Second, evidence demonstrates that the city of Kinshasa struggles to achieve the 6th SDG, which implies negative impacts on the 3rd and 4th SDGs related to health and equitable education for adolescent girls.